Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7475
Peer-review started: August 21, 2023
First decision: September 13, 2023
Revised: September 25, 2023
Accepted: October 8, 2023
Article in press: October 8, 2023
Published online: October 26, 2023
Although neonatal Staphylococcus aureus pneumonia is common and usually curable, it can also be refractory and life-threatening. Herein, we report a case of severe neonatal community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) necrotizing pneumonia with bilateral recurrent pyopneumothorax, respiratory failure, heart failure, and cardiac arrest. We hope our report will add to the understanding of this disease.
An 18-d-old boy presented with cough for five days, fever for three days, and dyspnea for two days. Preadmission chest radiograph revealed high-density shadows in both lungs. On admission, his oxygen saturation fluctuated around 90% under synchronized intermittent mandatory ventilation. He was uncon
Neonatal MRSA pneumonia can be refractory and lethal, especially in cases where necrotizing pneumonia leads to extensive lung necrosis and recurrent pneumothorax. Despite treatment with linezolid and other medical measures, it may still be ineffective. Currently, ECMO has been a remedial therapy, but if the lung tissue is too severely eroded to be repaired, it may be useless unless the infection can be controlled and lung transplantation can be performed. Regardless of whether ECMO is initiated, the key to successful treatment is to achieve control over the pneumonia caused by MRSA as soon as possible and to reverse lung injury as much as possible.
Core Tip: Neonatal pneumonia can usually be prevented, controlled and cured, regardless of whether it is caused by hospital-associated methicillin-resistant Staphylococcus aureus or community-acquired methicillin-resistant Staphylococcus aureus, but sometimes it is refractory or incurable. We report a case of severe neonatal community-acquired methicillin-resistant Staphylococcus aureus necrotizing pneumonia with bilateral recurrent pyopneumothorax, respiratory failure, heart failure, and cardiac arrest. We hope our report furthers our understanding of this disease.